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The prevalence and magnitude of childhood obesity are increasing dramatically. These investigators examined the effect of the degree of obesity on the prevalence of the metabolic syndrome and the relation of the syndrome to insulin resistance and C-reactive protein and adiponectin levels in a large multiracial, multiethnic cohort of children and adolescents. The relation of the syndrome to insulin resistance and C-reactive protein and adiponectin levels. In 1988, Reaven and colleagues 1 described “the metabolic syndrome” as a link between insulin resistance and hypertension, dyslipidemia, type 2 diabetes, and other metabolic abnormalities associated with an increased risk of atherosclerotic cardiovascular disease 2 in adults. Recent studies suggest that the metabolic syndrome may originate in utero. 2 , 3 Obesity, which is the most common cause of insulin resistance in children, 4 is also associated with dyslipidemia, 5 type 2 diabetes, 6 and long-term vascular complications. 7 – 9 In a sample of adolescents in the United States who were included in the third National Health and Nutrition Examination Survey (NHANES III), conducted between 1988 and . . .

Introduction Mobility disability affects nearly 15% of people aged 65 or over worldwide. Excess weight or obesity (OB), along with an accentuated loss of muscle strength (dynapenia), is recognized to be one of the most common risk factors for mobility impairment among the elderly. Objective To investigate the effect of a 12-week mixed power training (MPT high-velocity resistance training mixed with functional exercises) on physical function in obese older men exhibiting different severities of dynapenia. Methods Community-dwelling older men (69 ± 6 years) were assigned to the study if they were considered obese (OB, fat mass ≥ 25% body weight, BW) and to one of the two groups according to severity of dynapenia [(handgrip strength—HS)/BW]: type 1(OB-DY1) or type 2(OB-DY2), < 1 or 2SD from a young reference group. Participants followed a 12-week MPT, three times/week, 75 min/session. Main outcomes included the performance on the 4-m and 6-min walking tests, Timed Up and Go, stair and balance tests. Results and discussion At baseline, OB-DY1 performed better than OB-DY2 in all functional tests ( p  < 0.05). Following the intervention, medium-to-large training effect size (ES) were observed for fat (ES = 0.21) and lean (ES = 0.32, p  < 0.001) masses, functional performance (ES 0.11–0.54, p  < 0.05), HS (ES = 0.10, p  < 0.05) and lower limb muscle strength (ES = 0.67, p  < 0.001) and power (ES = 0.60, p  < 0.05). Training-by-group interaction showed that OB-DY1 lost more FM (ES = 0.11, p  = 0.03) and OB-DY2 improved more HS (ES = 0.19, p  = 0.006) than their counterparts. Conclusions Seniors with obesity and severe dynapenia have poorer physical function than those in the early stage of dynapenia. Both seem to benefit from a high-velocity resistance training mixed with functional exercises, although by slightly different pathways.

BackgroundThe aim of the study was to assess the long-term outcome in terms of weight loss and remission of comorbidities among the patients who had undergone LSG in an Indian setting.MethodsThis is a retrospective observational study of patients (BMI > 30 kg/m2) who underwent LSG having a minimum 6 months of follow-up data. Based on preoperative BMI, patients were grouped as class 1, 30 < BMI < 35 kg/m2; class 2, 35 < BMI < 40 kg/m2; and class 3, BMI > 40 kg/m2. Data on BMI and %EWL between three classes and among genders at different follow-up points for 7 years were compared.ResultStudy included 95 patients (mean age of 33.7 ± 11 years), and the preoperative mean BMI was 40.2 ± 5.1 kg/m2. At one year of surgery, 85.5% patients achieved > 50%EWL. The highest mean %EWL was found in class 1 (66.19%), followed by class 2 (56.73%) and class 3 (46.59%) at the sixth month follow-up. At the seventh year, %EWLs were 85.11% (class 1), 76.69% (class 2), and 62.98% (class 3) and the mean BMIs were 25.13 ± 3.09 kg/m2 (class 1), 26.86 ± 2.12 kg/m2 (class 2), and 31.07 ± 3.39 kg/m2 (class 3) and were significantly different (p < 0.05). At the last follow-up, though, the males showed slight weight regain; however, there were no statistical differences between the genders (p = 0.065).ConclusionOutcome from LSG was better in patients with BMI < 40 kg/m2 compared to the patients with BMI > 40 kg/m2. Remission of obesity-related comorbidities was observed with LSG in all groups and gender did not influence the outcome significantly.

BackgroundAbdominal adiposity is an important risk factor in the metabolic syndrome. Since BMI does not reveal fat distribution, waist-to-height ratio (WHtR) has been suggested as a better measure of abdominal adiposity in children, but only a few studies cover the preschool population. The aim of the present study was to examine BMI and WHtR growth patterns and their association regarding their ability to identify children with an elevated WHtR at 5 years of age.MethodsA population-based longitudinal birth cohort study of 1540 children, followed from 0 to 5 years with nine measurement points. The children were classified as having WHtR standard deviation scores (WHtRSDS) <1 or ≥1 at 5 years. Student’s t-tests and Chi-squared tests were used in the analyses.ResultsAssociation between BMISDS and WHtRSDS at 5 years showed that 55% of children with WHtRSDS ≥1 at 5 years had normal BMISDS (p < 0.001). Children with WHtRSDS ≥1 at 5 years had from an early age significantly higher mean BMISDS and WHtRSDS than children with values <1.ConclusionsBMI classification misses every second child with WHtRSDS ≥1 at 5 years, suggesting that WHtR adds value in identifying children with abdominal adiposity who may need further investigation regarding cardiometabolic risk factors.

ObjectiveTo investigate whether pre-pregnancy versus at delivery obesity status impacts TOLAC success rates in a modern cohort.Study designA retrospective cohort study of women undergoing TOLAC at a single institution from May 2007 to April 2016. Women were divided into four groups (not obese; class I, II, and III obesity) by pre-pregnancy and at delivery weight class. We investigated associations between obesity status at both time points and TOLAC success rates.ResultSix hundred and fourteen women underwent TOLAC; 444 (72.3%) had successful VBACs. We found no difference in rate of VBAC success across the four groups, both prior to pregnancy (p = 0.91) and at delivery (p = 0.75). We found no differences in secondary perinatal morbidity outcomes.ConclusionWe found no difference in TOLAC success rates stratified by obesity class. Properly counseling patients on TOLACs can lower rates of morbidity in women with high-risk conditions and comorbidities.

The World Health Organization defines overweight and obesity as the condition where excess or abnormal fat accumulation increases risks to health. The prevalence of obesity is increasing worldwide and is around 20% in ICU patients. Adipose tissue is highly metabolically active, and especially visceral adipose tissue has a deleterious adipocyte secretory profile resulting in insulin resistance and a chronic low-grade inflammatory and procoagulant state. Obesity is strongly linked with chronic diseases such as type 2 diabetes, hypertension, cardiovascular diseases, dyslipidemia, non-alcoholic fatty liver disease, chronic kidney disease, obstructive sleep apnea and hypoventilation syndrome, mood disorders and physical disabilities. In hospitalized and ICU patients and in patients with chronic illnesses, a J-shaped relationship between BMI and mortality has been demonstrated, with overweight and moderate obesity being protective compared with a normal BMI or more severe obesity (the still debated and incompletely understood “obesity paradox”). Despite this protective effect regarding mortality, in the setting of critical illness morbidity is adversely affected with increased risk of respiratory and cardiovascular complications, requiring adapted management. Obesity is associated with increased risk of AKI and infection, may require adapted drug dosing and nutrition and is associated with diagnostic and logistic challenges. In addition, negative attitudes toward obese patients (the social stigma of obesity) affect both health care workers and patients.

In this cross-sectional analysis of data from overweight or obese children and young adults from NHANES (1999–2012), severe obesity was associated with an increased prevalence of cardiometabolic risk factors, particularly in boys and young men. The prevalence of severe obesity among children and young adults has increased in recent years 1 and has led to a heightened awareness and concern about the cardiovascular and metabolic health of persons in this age group. In 1999–2004, almost 4% of children and young adults in the United States 2 to 19 years of age were classified as having severe obesity, 2 and as recently as 2011–2012, the prevalence of severe obesity increased to approximately 6% in this age group 1 ; however, the prevalence of cardiometabolic risk factors accompanying severe obesity in these children and young adults is unclear. Cardiometabolic risk . . .

To analyse changes in the distribution of BMI in Australia between 1980 and 2000. Data were from the 1980, 1983 and 1989 National Heart Foundation Risk Factor Prevalence Study, the 1995 National Nutrition Survey and the 1999/2000 Australian Diabetes, Obesity and Lifestyle Study. Survey participants were aged 25-64 years and resident in Australian capital cities. BMI was calculated as weight divided by height squared (kg/m2), where weight and height were measured using standard procedures. Mean BMI was higher in 2000 than 1980 in all sex and age groups. The age-adjusted increase was 1.4 kg/m2 in men and 2.1 kg/m2 in women. The BMI distribution shifted rightwards for all sex and age groups and became increasingly right-skewed. The change between 1980 and 2000 ranged from a decrease of 0.04 kg/m2 at the lower end of the distribution for men aged 25-34 years to an increase of 7.4 kg/m2 at the higher end for women aged 55-64 years. While the prevalence of obesity (BMI >or= 30 kg/m2) doubled, the prevalence of obesity class III (BMI >or= 40 kg/m2) increased fourfold. BMI in urban Australian adults has increased and its distribution has become increasingly right-skewed. This has resulted in a large increase in the prevalence of obesity, particularly the more severe levels of obesity. It will be important to monitor changes in the different classes of obesity and the extent to which obesity interventions both shift the BMI distribution leftwards and decrease the skew of the distribution.

Obesity is a serious medical condition worldwide, which needs new approaches and recognized international consensus in treating diseases leading to morbidity. The aim of this review was to examine heterogeneous links among the various phenotypes of obesity in adults. Proteins and associated genes in each group were analysed to differentiate between biomarkers. A variety of terms for classification and characterization within this pathology are currently in use; however, there is no clear consensus in terminology. The most significant groups reviewed include metabolically healthy obese, metabolically abnormal obese, metabolically abnormal, normal weight and sarcopenic obese. These phenotypes do not define particular genotypes or epigenetic gene regulation, or proteins related to inflammation. There are many other genes linked to obesity, though the value of screening all of those for diagnosis has low predictive results, as there are no significant biomarkers. It is important to establish a consensus in the terminology used and the characteristics attributed to obesity subtypes. The identification of specific molecular biomarkers is also required for better diagnosis in subtypes of obesity.

The purpose of this study was to evaluate obesity classifications from body fat percentage (BF%), body mass index (BMI), and waist circumference (WC). A total of 451 overweight/obese active duty military personnel completed all three assessments. Most were obese (men, 81%; women, 98%) using National Institutes of Health (NIH) BF% standards (men, >25%; women, >30%). Using the higher World Health Organization (WHO) BF >35% standard, 86% of women were obese. BMI (55.5% and 51.4%) and WC (21.4% and 31.9%) obesity rates were substantially lower for men and women, respectively (p < 0.05). BMI/WC were accurate discriminators for BF% obesity (theta for all comparisons >0.75, p < 0.001). Optimal cutoff points were lower than NIH/WHO standards; WC = 100 cm and BMI = 29 maximized sensitivity and specificity for men, and WC = 79 cm and BMI = 25.5 (NIH) or WC = 83 cm and BMI = 26 (WHO) maximized sensitivity and specificity for women. Both WC and BMI measures had high rates of false negatives compared to BF%. However, at a population level, WC/BMI are useful obesity measures, demonstrating fair-to-high discriminatory power.